Healthcare, Senior Living, Economics
Information and discussion on general federal health policy and politics – including Medicare, Health Reform and all other subjects Fed.
After CMS nixed the mandatory expansion provisions for Bundled Payments and reduced the metro areas participating in CJR (joint replacement), the prospects for post-acute provider involvement in non-fee-for-service initiatives (payments and incentives based on disease states and care episodes) went in to limbo. With a fair amount of excitement and trepidation building on the part of the … Read more
I’m not sure how many of my readers are following the subject and CMS stance/policy on interoperability among providers but the concepts and resultant debate are rather interesting. I am trying to encourage as many clients and readers to tune-in on this subject as the implications are sweeping – positively and negatively. Interoperability in this … Read more
Last Friday, CMS released the contents of its annual proposed rule updating the SNF PPS plus (as always), fine tuning certain related programmatic elements. Final Federal Register Publication is set for May 8. (Anyone wishing the PDF version may download it from the Reports and Other Documents page on this site or access it here … Read more
What do Morningside Ministries in San Antonio, Genesis Healthcare, Signature Healthcare, HCR ManorCare, and Syverson Health and Rehab in Wisconsin have in common? Answer: A terminal relationship with Medicaid. While Genesis isn’t “dead” yet, it is fundamentally on life support with a stock price of $1.50 per share and a Medicaid payer mix averaging 73%. HCR ManorCare is … Read more
As 2017 closed, a number of projects kept me busy right up to the Christmas holiday. Among these projects was a focus on the SNF industry current and its fortunes going forward, principally driven by clients in the investment industry. With REIT troubles, portfolio defaults on the part of HCR and Consulate, Sabra divesting Genesis facilities … Read more
It is rare that I push or endorse any product on this site. This is an exception worth making. http://hcmarketplace.com/survey-success-for-long-term-care The book is authored by my wife who also heads the Clinical Compliance practice within H2 Healthcare, LLC – the firm that I head. She is our Senior Partner as well as the firm’s Chief … Read more
A few weeks back, I wrote a piece regarding Medicaid and its ties to the fortunes (lack thereof ) of some the largest SNF provider groups. Today a high percentage of resident census connected to Medicaid as a payer source is the largest contributor to the flagging financial condition of Genesis, HCR/ManorCare, Signature, and others. With … Read more
There is an old joke/riddle that goes like this: “Where does an 800 lb. gorilla sit? Answer: Anywhere it wants to”. For SNFs and REITs today, that gorilla is Medicaid. Sure, there are numerous industry headwinds that SNFs face in terms of financial performance; Rising percentage of Medicare Advantage patients as part of the payer … Read more
CMS has released the text of the proposed rule with regard to bundled payment status (see my post from earlier today). The link is here – https://s3.amazonaws.com/public-inspection.federalregister.gov/2017-17446.pdf In summary, here are the high points. No advance of the cardiac and upper femur fracture/traumatic joint repair/replace bundles for 2018. The reason? As stated in my earlier … Read more
Within the last few days, CMS/HHS sent a proposed rule to OMB (Office of Management and Budget) that would cancel the planned January 2018 roll-out of the (mandatory) cardiac and traumatic joint repair/replacement bundles. Specifically, CMS was adding bypass and myocardial infarction DRGs to the BPCI (Bundled Payments for Care Improvement) along with DRGs pertaining to … Read more